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A    N 

INAUGURAL  DISSERTATION 


O    H 


Worms  of  the  Human  Inteftines. 


SUBMITTED  TO  THE  EXAMINATION 
OF       THE 

Rev.  WILLIAM  LINN,  p.d.  p.t.  Prefidentj 

AND     TO     THE 

TRUSTEES   and   FACULTY 

O    F 

QUEEN's  COLLEGE,    NEW-JERSEY; 

FOR  THE  DEGREE  OF 

DOCTOR  of  MEDICINE, 

WITH  THE  RIGHTS  AND  IMMUNITIES  THEREUNTO 
APPERTAINING. 


By  HENRY  M.  VAN  SOLINGEN, 

OF     NEW- YORK. 


MISERIS    SUCCURRERE    DISCO, 
VlRG. 


NEW-YORK: 

PRINTED  BY  T.  AND  J.  SWORDS,  NO.  2J,  WIT-LIAM-STREET, 

—  I792.— 


H4-!il 


/L  s-s 


^  (0// 

/79& 


TO   THE    REVEREND 

WILLIAM  LINN,  d.  d. 

Prefident,  p.  t.  of  Queen's  College,  New-Jerfey; 

AND, 

Minifter  of  the  Reformed  Dutch  Church  in  the  City  of  New-York; 

WHO, 

From  affiduous  Attention  to  the  Duties  of  his  facred  Profeffion, 
and  by  his  eminent  Learning  and  Piety,  has  contributed  to 

The  Advancement  of  Religion, 

AS    WELL    AS 

The  Good  and  Peace  of  Mankind: 


DISSERTATION 

IS       INSCRIBED, 

With  every  Mark  of  Refpecl, 
By  his  obliged, 

Humble  Servant, 

The  AUTHOR. 


A  N 


INAUGURAL  DISSERTATION 


O     N 


Worms  of  the  Human  Inteftines. 


INNUMERABLE  are  the  caufes  that  give  rife 
to  difeafes  incident  to  man :  fome  of  them,  whilft 
they  appear  innocent,  and  portend  little  danger, 
are,  at  the  fame  time,  both  ferious  in  their  nature 
and  termination.  For  the  truth  of  this,  we  need 
only  advert  to  the  inflance  of  human  worms  \  the 
consideration  of  which  I  propofe  to  make  the 
fubjecl:  of  the  following  differtation. 

Every  part  of  the  human  body  has  indeed 
been  known  to  be  affected  with  worms ;  but  it  is 
only  thofe  infefting  the  inteftinal  canal  that  arc 
particularly  to  be  confidered  here.  Their  divifion 
is  generally  into  three  kinds — Afcarides,  Lum- 
bricus  teres^  and  T^nia^  or  Lumbricus  latus. 


Of 


A  DISSERTATION  ON  WORMS 


Of  the  ASCARIDES, 


THE  afcarides,  Galen  has  defined,  as  "  be- 
ing fmall  worms,  generated  chiefly  in  the  lower 
part  of  the  interlines.53  They  are  of  a  fmall  fize, 
and  pointed  at  both  extremities.  The  head,  in 
moil,  is  not  eafily  detected.  Their  colour  is 
generally  white,  but  in  fome  it  has  been  found 
changed  by  the  feces.  They  abound  in  great 
numbers  in  the  colon  and  rectum,  and  are  frequent- 
*  ly  thrall  out  with  the  excrements.  Baglivius* 
informs  us,  he  knew  a  young  man,  who,  being 
fuddenly  attacked  with  diarrhoea,  voided  an  hun- 
dred. They  excite  an  intolerable  itching,  efpeci- 
ally  about  the  verge  of  the  anus,  tenefmus,  and 
other  troublefome  fymptoms. 

The  afcarides  have  a  great  refemblance  with 
thofe  worms  which  we  frequently  fee  in  cheefe,  in 
point  of  colour,  figure,  and  fize.  Profefibr  Van 
Bceverenf  believed  them  to  derive  their  origin 
thence ;  and  Van  Sweiten J  knew  a  man,  who,  as 
often  as  he  ate  white  cheefe,  two  days  after  felt  a 
troublefome  itching  about  the  anus,  occafioned 
by  the  afcarides. 

But 

*  Epift.  ad  Andry,  p.  698. 
f  Differtat.  Inaug.  p.  31. 
%  Com.  in  Ap.  p.  1359. 


OF  THE  HUMAN  INTESTINES.  .        J 

But  cheefe  worms  are  found  to  differ  widely 
from  afcarides.  They  undergo  a  change  in  their 
form,  which  the  afcarides  do  not— They  are  blunt- 
ed at  the  extremities,  and  the  afcarides  are  fharp. 


Of  the  LUMBRICI  TERES. 


THE  lumbrici  teres,  or  round  and  long  worms, 
with  which  children  are  ufually  troubled,  are  (by 
Hippocrates  called  fop*?  rpyyvhaq,  by  Celfus  Teres,) 
commonly  about  fix  inches  long,  and  fometimes 
a  foot  •,  but  the  male  is  generally  fmaller  than  the 
female.  They  are  of  the  thicknefs  of  a  goofe- 
quill.  Their  colour  is  white,  and  both  extremi- 
ties terminate  in  a  point. 

The  number  prefent  in  the  bowels  at  a  time  is 
very  various,  fometimes  only  one,  two,  or  three. 
But  if  we  may  judge  from  the  furprifing  number 
of  eggs  which  have  been  feen  in  them  by  means 
of  the  microfcope,  we  will  not  be  aftonifhed  at 
the  amazing  number  of  worms  prefent  in  fome 
perfons,  which  we  find  related  by  fome  authors. 
Clericus  mentions  the  cafe  of  a  boy  and  girl,  who 
were  killed  by  taking  arfenic,  having  upwards  of 
an  hundred  of  the  teres  lumbrici  in  their  inteftines. 

Gabucinus 


8  A  DISSERTATION  ON  WORMS 

Gabucinus  faw  one  hundred  and  feventy-feven  that 
were  voided  at  one  turn  by  a  girl  •,  and,  to  come 
nearer  home,  a  woman  in  this  city,  a  patient  of 
mine,  pafTed,  in  four  and  twenty  hours,  consider- 
ably more  than  an  hundred,  and  moft  of  which 
were  pretty  long. 


Of  the    TMNIA. 


THE  taenia,  or  lumbricus  latus,  by  fome  is 
called  the  Solitary  Worm^  becaufe  it  has  been  be- 
lieved to  be  always  alone.  Hippocrates  called  it 
Tumx ;  hence  its  denomination,  Tape-worm. 

No  fpecies  of  inteftinal  worms  is  more  deftruc- 
tive  to  human  nature,  or  more  difficult  to  be  to- 
tally deftroyed:  It  fometimes  equals  in  length 
the  whole  inteftinal  canal;  the  breadth  of  it  is 
various,  both  in  the  fame  worm,  and  in  different 
worms. 

It  confifts  of  a  great  number  of  joints,  fimply 
connected  together ;  and  thefe  joints  are  fo  articu- 
lated, that  the  extreme  edges  of  the  preceding 
come  over  the  fubfequent.  The  extremity  where- 
on the  head  is  fet,  is  fmaller  than  the  other,  and 

feme 


OF. THE  HUMAN  INTESTINES.  9 

fometimes  not  an  eighth  part  fo  broad :  the  joints 
towards  the  head  are  confiderably  fhorter  than  to- 
wards the  tail,  arid  they  feem  gradually  to  grow 
longer  from  the  head. 

The  colour  of  the  taenia  is  very  white,  being 
moftly  turgid  with  chyle, 

Four  fpecies  are  enumerated  by  Linnaeus.  The 
firft  is  diftinguifhed  by  fmall  orifices,  or  mouths, 
placed  alternately  on  the  margin  of  each  joint,  and 
is  called  Solium  Andriiy  Lumbricus  latus  Couleti  et 
Vermis  cucurhitinus  Plateri. 

The  fecond  differs  in  having  two  openings  on 
one  fide  only  of  a  joint,  and  is  called  Taenia  vul- 
garis Andrii^  Taenia  primi  generis  k  Clerc, 

The  third  has  only  one  foramen  to  be  difcover- 
ed  in  the  fide  of  a  joint,  and  this  fpecies  Linnaeus 
mentions  to  have  been  very  rarely  found. 

The  fourth,  and  laft  fpecies,  has  two  little 
mouths  in  the  margin  of  each  joint,  one  oppofite 
to  the  other. 

Vast  quantities  of  this -worm  are  voided  by 

patients  for  feveral  years  together-,  it  is  rarely 

B  ever 


IO  A  DISSERTATION  ON -"WORMS 

ever  (ten  whole.  We  have  lipon  record  inftances 
of  many  yards  having  been  voided  at  a  time.* 
Glaus  Borrichius,  a.  celebrated,  phyfician  of  Co- 
penhagen, of  U\q  laft  century,  tells  us  of  a  patient 
of  his  who  paiTed  eight  hundred  feet  of  this  fort 

of  worm,  in  feveral  pieces,  in  the  fpace  of  a  year. 

- 

Doctor  Tyfon,  of  London,  had  a  mnilar  in- 
itance  of  great  quantities  of  this  worm  being 
voided  for  feveral  years  together,  in  pieces  from 
two  to  fix  yards  in  length  *,  which  all  put  together 
would  exceed  the  length  of  that  of  Borrichius. 

But  though  the  exact  length  of  this  worm  can- 
not be  afcertained,  yet  it  is  undeniable  that  it  is 
prodigiously  long,  as  appears  by  thofe  pieces  men- 
tioned above.  The  illuftrious  Van  Dceveren  re- 
lates the  cafe  of  a  young  man,  who  ejected  a  bro- 
ken piece  of  the  taenia  that  meafured  40  cubits. f 

In  the  Philofophic'a!  Tranfaclions  we  have  a 
description  of  apart  of  this  worm  that  contained 

507  joints  •,  and,  to  conclude  this  part,  we  mall 
inftance  one  other  cafe  that  the  illuftrious  Boer- 

haave 

*  Doclor  Buxton,  a.phyfician  of  this  city,  has  in  his  poflef- 
fion,  a  broken  part  of  a  tsnia,  24  feet  long5  and  with  its 
he?d  cemp'ete. 

■f  A  cubit  is  18  inches. 


OF  THE  HUMAN  INTESTINES.  II 

haave  defcribes,    which  he    fays  meafured  300 
cubits,  and  confuted  of  21,600  joints. 

It  is  unknown,  as  yet,  whether  each  joint  fe- 
parately  conftitutes  a  whole  animal.  It  is  won- 
derful that  each  part  poiTeiTes  the  fame  power 
within  itfelf  as  the  whole  animal  :*  it  fupports  life, 
moves,  and  adheres  to  the  other  parts.  Some  in- 
jections, tending  to  afcertain  this  truth,  k^m  to 
prove  that  thofe  many  joints  we  fee  in  each  taenia 
conftitute  only  one  worm. -f- 


Ofthe  ORIGIN  and  NOURISHMENT  of 
INTESTINAL  WORMS. 

THE  various  opinions  which  have  been  hand- 
ed down  of  the  origin  and  nourijhment  of  worms, 
are  not  expedted  to  be  prefented  in  fo  fmall  a  work 
as  this.  Some  ancient  authors  believed  them  to 
arife  from  putridity,  %  and  others  to  have  been 
coeval  with  the  body.  Galen,  writing  upon  this 
fubjedfc,  fays,  "  That  thofe  worms  do  not  arife 
from  a  feed,  but  from  putrid  matter."  The 
celebrated  phyfician,  De  Lrfle,  obferved  m  his 

own 

*  A  fimilar  in  (lance  is  in  the  Polypus. 
f  Doflor  Monro's  Works. 
t  Galen. 


12  A  DISSERTATION  ON  WORMS 

own  daughter,  a  child  eleven  weeks  old,  whole 
nefts  of  worms ;  and  the  mother,  as  yet,  had  af- 
forded no  other  kind  of  nourimment  but  that  of 
the  breaft.  Hence  he  concludes  the  worms  to  be 
congenial  with  the  body.  The  eminent  phyfician 
Van  Dceveren,  collected  many  obfervations  of 
fcetufes  that  had  worms  in  the  interlines  whilft  yet 
in  the  mother's  womb.  It  is  however  believed 
to  be  a  univerfal  law  of  nature,  *<  that  every  ani- 
mal is  generated  from  an  egg."  This  appears 
efpecially  to  be  the  cafe,  fince  eggs  have  been  dis- 
covered in  the  ovaria  of  viviparous  animals. — 5 
From  the  great  variety  of  opinions  delivered  to 
us  concerning  the  generation  of  worms,  it  will 
not  be  wondered  at,  that  the  mod  learned 
men  in  natural  hiftory  have  found  fo  much  diffi- 
culty upon  the  fubject.  In  Baglivius  we  read  of 
worms  {Qtn  in  the  pericardium  equalling  in  length 
the  whole  palm  of  the  hand. 

Du  Verney  tells  us  of  a  child,  five  years  oldv 
that  conftantly  complained  of  a  pain  about  the 
root  of  the  nofe  •,  fhe  kept  her  bed  with  a  flow 
fever — convulfions  at  length  feized  her,  and  me 
died :  after  her  death  a  worm  was  found  in  the 
longitudinal  finus  of  the  brain,  five  thumbs 
breadth  long,  and  not  unlike  an  earth  worm. 

SWAMMERDAM, 


OF  THE  HUMAN  INTESTINES.  jB 

Swammerdam,  who  was  fo  fkilful  and  quicks 
lighted,  after  carefully  ccnfidering  all  things,  con- 
feftes  "  it  is  the  moft  difficult  thing  in  the  world 
to  explain  by  what  means  worms  are  generated  in 
living  bodies,  &c. — I  acknowledge,"  fays  he, 
"  for  my  part,  that  I  have  met  with  fo  few 
fatisfactory  experiments  in  this  matter,  that  I  have 
not  yet  any  thorough  knowledge  of  the  fubjecT. : 
although  I  have  feen  many  worms,  and  worms 
of  various  forms,  in  the  living  and  moving  bodies 
of  terreftrial  as  well  as  aquatic  and  serial  animals, 
but  I  cannot,  in  this  matter,  come  to  any  folid 
and  certain  determination.5* 

When  worms  are  prefent  in  the  inteftines,  they, 
no  doubt,  muft  be  nourifhed,  as  they  are  fupport- 
ed  and  grow ;  and  this  nourifhment  is  afforded  by 
our  aliment.  Some  are  of  opinion  that  they  live 
upon  the  chyle  •,  and  others  think  they  live  not 
only  on  the  chyle,  but  on  the  blood  likewife. — 
Van  Doeveren  mentions  a  taenia,  which  a  friend  of 
his  faw  expelled,  where  a  drop  of  blood  was  if- 
fuing  from  the  orifice,  or  mouth.  We  have  like- 
wife  a  defcription  of  a  worm*  a  foot  and  a  half 
long,  and  an  inch  and  a  half  diameter,  which  was 
voided  by  the  anus ;  it  was  full  of  blood,  and, 
for  feveral  days  after  its  expulfion,  the  perfon  loft, 

to 

*  Med.  Eff.  and  Obf.  vol.  ii.  p.  336. 


14  A  DISSERTATION  ON  WORMS 

to  appearance,  fome  pounds  of  blood.  The  worrr* 
was  dead,  and  made  up  of  a  number  of  rings 
like  the  earth-worm. 

It  appears  they  draw  nourifhment  fometimes 
from  the  fubftance  of  the  ftomach  and  bowels,  for 
we  very  frequently  difcover  them  in  the  cavity  of 
the  abdomen,  and  a  perforation  made  into  the  in- 
terlines. Heifter  opened  the  corpfe  of  a  boy, 
kvm  years  old,  who  had  been  troubled  for  fome* 
time  with  grievous  pains  of  his  abdomen-,  and 
although  he  had  an  excellent  appetite,  yet  he  ap- 
parently died  of  emaciation.  In  the  abdomen  was 
found  a  quantity  of  yellow  water,  which  being 
abforbed,  he  difcovered  many  round  and  long 
worms ;  and  though  the  body  was  opened  the  day 
after  its  death,  he  found  only  one  living  worm 
among  the  great  number  prefent.  The  fmall  in- 
terlines were  perforated  with  many  holes,  and  con- 
tained yet  many  more  worms,  but  every  one  dead.* 
We  have  the  hiftory  of  a  young  woman's  cafe 
who  had  furTered  under  many  difeafes,  and  died 
in  confequence  of  worms  -,  her  abdomen  was  found 
abounding  with  them.  In  other  cafes  not  the  in- 
terlines alone  were  perforated,  but  the  heart  and 
liver  were  eroded. — The  late  Doclor  Bond,-f  of 

Philadelphia, 

*  Morgag.  Let.  xxxlv.  Art.  36. 
+  Med.  Obierv.  voh  i.  p.  72. 


OF  THE  HUMAN  INTESTINES.  Ij 

Philadelphia,  relates  a  cafe  of  a  Quaker  lady  who 
had  confiderable  part  of  the  liver  eroded  by  a 
worm.* 


Of  the  CAUSES  of  WORMS. 


INFANTS  labour  more  frequently  and  griev- 
oufly  under  worms  than  adults-,  hence  arife  m 
them  other  difeafes  :  their  interlines  being  replete 
with  a  glutinous  matter  from  the  nature  of  then- 
aliment,  which  affords  a  nidus  for  worms.  It  is 
daily  to  be  noticed  that  children  of  the  poor,  far 
more  often  than  others,  labour  under  this  com- 
plaint, on  account  of  the  want  of  proper  food. 

Many  crude  indigestible  vegetables,  immature 
fruits,  legumina,  fweets,  cheefe  and  frefh  fifh, 
tend  exceedingly  to  produce  the  pituitous  matter 
which  favours  their  production,  particularly  In 
perfons  of  debilitated  habits. 

The  feafon  of  the  year  favours  much  the  pre- 
difpofition  to  worms.  It  is  mentioned  by  Van 
Swieten,f  that  it  was  obferved  at  Beziers,  in  the 

year 

*  I  am  informed  the  celebrated  Doctor  Monro  (hews  pre- 
parations of  inteftines  which  were  actually  eroded  by  worms. 
f  Com.  in  aph.  1362. 


1 6  A  DISSERTATION  ON  WORMS 

year  1730,  to  have  feized  many  in  the  manner  of 
an  epidemic,  Although  worms  were  frequent  at 
other  feafons  among  the  inhabitants,  yet,  in  that 
year,  perfons  of  both  fexes,  of  all  ages  and  confti- 
tutions,  were  afflicted  with  them,  and  that  to  fuch 
a  degree  as  to  prove  mortal  to  fome.  Remedies 
were  administered  in  vain,  if  not  given  very  ftrong 
and  powerful,  that  the  worms  might  be  forced 
out,  either  upwards  or  downwards — many  of 
which  came  alive  from  the  body. 


The  SYMPTOMS  of  WORMS. 

IT  is  not  furpriflng  that  worms  produce  {0 
many  evils,  if  we  only  confider  the  great  fenfibility 
of  the  interlines,  which  exceeds  that  of  almoft 
every  other  part  •,  and  the  fympathy,  which  fubfifts 
between  them  and  every  other  part  of  the  body : 
Then,  if  we  confider  the  ufes  they  are  deftined  to 
in  the  animal  ceconomy,  with  the  affections  that 
are  attendant  on  worms,  as  fordes,  gnawing  pains, 
fpafms,  flatus,  tormina,  &c.  it  will  fufnciently 
appear  that  this  difeafe  is  at  times  exceedingly 
diftr  effing. 

The  numerous  fymptoms  which  are  attendant 
on  worms  in  the  bowels,  affect  much  more  fenfi- 

bly 


OF  THE  HUMAN   INTESTINES.  IJ 

bly  infants  than  adults,  which  is  plainly  enough 
understood  by  perfons  who  are  acquainted  with 
the  animal  ceconomy.  Thefe  are  as  follow: — 
The  abdomen  becomes  hard  and  diftended  with 
air,  rumbling  noife  takes  place  frequently  in  it, 
fetid  breath,  naufea  and  vomiting  -,  the  appetite 
is  at  times  impaired,  then  again  it  is  ravinous  and 
infatiable  \  heart-burn,  hiccup,  and  tranfient  pains 
of  the  belly,  which  are  fevere  and  lancinating 
v/hen  the  ftomach  is  empty :  a  Deflation  or  remiflion 
of  thefe  pains  after  taking  of  food,  great  thirft  and 
palenefs  of  the  countenance.  The  adnata  of  the 
eyes  is  tinged  with  a  leaden  colour- — the  inferior 
palpebral  become  tumid,  are  circumfcribed  with 
a  bluim  ring,  and  the  pupils  are  dilated  j*  an  itch- 
ing of  the  nofe — the  upper  eye-lid  becomes  enlarg- 
ed, as  if  inflated — frequent  ftarting  in  fleep,  and 
grinding  of  the  teeth — febrile  fymptoms  occur 
throughout  the  day,  with  pain  of  the  head,  and 
fometimes  delirium — an  involuntary  difcharge  of 
faliva,  particularly  during  fleep. 

Doctor  Friend  enumerates,  among  the  moft 
frequent  fymptoms  of  worms,  a  dry  cough,  which 
is  excefTively  troublefome. 

C  The 

*  It  may  be  doubted  whether  the  dilatation  of  the  pupils 
may  be  confidered  as  a  fymptom  of  worms,  as  the  fymptoms 
of  hydrocephalus  are  very  fimilar  to  thofe  of  worms,  and  are 
often  confounded. 


I  8  A  DISSERTATION  ON  WORMS 

The  belly  is  moftly  bound — The  urine  is 
frothy  and  of  a  whitilh  appearance. 

Many  other  worfe  fymptoms  arife  from  thek 
prefence,  as  eroding  and  perforating  the  inteftines3 
as  mentioned  already :  nor  are  examples  wanting 
to  mew  that  worms  give  rife  to  various  convulfive 
and  nervous  affections. 

The  fymptoms  of  afcarides,  though  not  very 
dangerous,  yet,  if  their  number  become  great, 
and  happen  to  perfons  of  fenfible,  delicate  habits, 
they  produce  much  uneamiefs  in  the  body.  They 
induce  an  intolerable  itching  in  the  inteftinum  rec- 
tum, and  this  itching  may  increafe  fo  much  that, 
by  the  confent  of  the  different  parts,  it  may  be 
propagated,  and  excite  fpafmodic  affections  in  the 
neighbouring  parts,  as  difficulty  of  voiding  urine. 
ftrangury,  hemorrhoidal  flux,  &c. 


DIAGNOSTIC  SIGNS  of  WORMS, 


THE  many  dangerous  fymptoms  induced  by 
the  prefence  of  worms  in  the  body,  render  it  very 
necefTary  that  a  phyncian  mould  understand  tht 
fymptoms  indicating  the  real  nature  of  the  difeafe, 

leafl 


OF  THE  HUMAN  INTESTINES.  1 9 

leaft  he  prefcribe  remedies  proper  for  worms,  when 
the  complaint  requires  very  different  medicines. 

In  infants  worms  are  mamfeftly  more  eafily  de- 
tected than  in  adults. 

Each  fpecies  of  worm  are  faid  to  have  peculiar 
iigns  and  fymptoms  diftinguifhing  their  prefence : 
Thus  pains,  gripings,  heart-burn,  and  trouble- 
fome .  fpafmodic  fymptoms,  more  frequently  indi- 
cate the  teres  lumbrici  than  any  other.  The 
taenia,  it  is  faid,  is  accompanied  with  a  much 
more  depraved  appetite,  emaciation  and  iyncope, 
with  an  enlarged  abdomen,  &c.  though  this  latter 
often  happens  when  the  teres  alone  are  prefent. 
The  proper  iigns  of  the  afcarides  are  a  vehement 
itching  of  the  anus,  tenefmus,  and  frequent  incli- 
nation to  ftool.  Notwithstanding,  all  thefe  fymp- 
toms may  occur,  yet  no  worms  may  be  prefent , 
but,  when  worms  are  difcharged  from  the  bowels, 
it  is  prefumable  that  the  fymptoms  proceed  from 
that  fource. 

In  the  Edinburgh  Medical  Effays,  Profeffor 
St.  Clair*  relates  a  cafe  of  this  nature — A  boy, 
four  years  of  age,  complained  of  pains  of  his 
ftomach,  itching  of  the  nofe,  ftartings  in  deep, 

and 
*  Vol.  ii.  p.  294. 


2o  A  DISSERTATION  ON  WORMS 

and  would  wake  very  much  terrified ;  and  after- 
wards, fleeping  or  waking,  he  kept  continually 
rubbing  his  nofe— convulfions  fucceeded,  and  he 
died  the  fixth  day — -having  tried  many  remedies 
indicated  in  fuch  a  cafe.  The  body  was  opened, 
and  the  ftomach  and  inteftines  difTeeted  through- 
out their  whole  length — no  worms  appeared^ 
but  about  two  ounces  of  a  vifcid  fubftance,  like 
gelly,  was  found  fituated  at  the  beginning  of  the 
inteftinum  jejunum. 

The  Illuftrious  Morgagni*  mentions  another 
cafe  of  the  falacy  of  fymptoms— A  boy,  feventeen 
months  old,  was  fuddenly  feized  with  a  diarrhoea, 
attended  with  cough  and  itching  of  the  nofe: 
in  a  few  days  he  died.  Upon  infpecling  the  body, 
there  were  no  worms  found  in  the  interlines. 

Doctor  Armftrong-f"  relates  a  cafe  of  a  boy 
u  who  lay  very  ftupid,  pulfe  low  and  quick,  tongue 
foul,  and  breath  fetid,  he  had  no  found  fleep, 
but  flumbered  with  his  eyes  half  fhut ;  he  grind^ 
ed  his  teeth,  had  inward  fits,  and  was  fometimes, 
threatened  with  convulfions- — after  a  few  days  he 
died.  The  body  was  opened,  and  the  ftomach 
and  the  whole  inteftinal  canal  examined,  but  not 
the  leaft  appearance  of  worms." 

*  Epifc.  xxxi.  art.  5.  de  caufis  et  fed.  rnorb. 
T  Difeafes  of  Children. 


* 


OF  THE  HUMAN  INTESTINES.  21 


The  CAUSE  of  the  SYMPTOMS. 


ALMOST  all  the  fymptoms  of  worms  may  be 
explained  from  the  wafte  of  the  chyle,  a  certain 
matter  furnimed  by  the  worms,  and  from  irrita- 
tion of  the  interlines. 

By  the  worms  confuming  the  chyle,  may  be 
explained  the  hunger,  paienefs,  emaciation,  debi- 
lity, and  bound  belly,  with  the  belching  of  wind, 
and  rumbling  noife  of  the  bowels. 

From  the  matter  furnimed  by  the  worms,  we 
may  underftand  the  caufes  of  diarrhoea  and  fetid 
breath. 

By  irritating  the  inteftines,  they  caufe  naufea, 
vomiting,  fyncope,  itching  of  the  nofe,  and  va- 
rious convuliive  affections,  as  epilepfy,  convul- 
sions, &c. 


The  METHOD  of  CURE. 


FROM  the  nature  and  fituation  of  worms,  the 
following  indications  feem  aptly  to  arife. 

I.  To 


22  A  DISSERTATION  ON  WORMS 

1,  To  deftroy  the  neft  of  worms,  diflodge  them 
of  their  lurking-places,  and  kill,  or  induce 
fuch  a  ftate  of  the  ftomach  and  inteftines,  as 
is  incompatible  with  their  existence. 

II.  Being  diflodged  or  killed,  they  are  to  he 
expelled  from  the  body. 

The  firit.  indication  very  often  fuffices  alone,  as 
worms  being  removed  from  their  Situations,  and 
weakened,  are  often  expelled  with  the  fceces,  by 
the  periftaltic  motion  of  the  inteftines  -,  but  as  this 
is  not  univerfally  the  cafe,  it  becomes  neceffary  to 
form  another  indication  for  their  expulfion. 

THWemedies  recommended  for  the  firft  inten- 
tion may  be  divided  into  fuch  as  act, 

i.  By  their  poifonous  quality  -, 

2,  By  their  mechanical  power ;  and, 

3,  By  the  conjoined  action  of  each  of  thofe. 

Those  which  act  by  their  poifonous  quality  are 
cabbage-tree  bark,  Indian  pink,  male  fern,  worm- 
feed,  and  common  fait. 

Cabbage-tree  bark.]  It  has  a  mucilaginous 
fweetifn  tafte,  and  a  difagreeable  fmelU  it  is  given 
in  form  of  powder,  decoction,  and  extract.     It 

produces 


OF  THE  HUMAN  INTESTINES.  2j 

produces  fome  ficknefs  and  purging,  fometimes 
violent  effects,  as  vomiting,  delirium,  and  fever  •, 
which  are  fuppofed  to  arife  from  an  over  dofe, 
and  are  faid  to  be  relieved  by  taken  warm  water, 
carter-oil,  or  a  vegetable  acid.  In  the  Well- 
Indies,  where  its  ufe  is  better  underrtood,  they 
ufe  it  by  way  of  infufion,  and  begin  with  fmall 
dofes,  and  when  cautioufly  and  properly  adminis- 
tered, it  affords  an  excellent  anthelmintic,  e Speci- 
ally for  the  expulsion  of  the  lumbrici. 

Indian  pink.']  This  plant  is  made  very  fre- 
quent ufe  of  in  this  country,  and  it  proves  a  pretty 
certain  vermifuge.  It  is  commonly  adminirtered 
in  infufion  j  and  its  purgative  effect,  aflirted  by 
fome  fuitable  medicine. 

From  the  experiments  of  Doctor  Francis 
Home,  it  appears,  that  it  produced  the  expulfion 
of  worms,  when  they  had  evaded  other  remedies. 
He  fays  he  found  it  necenary  to  continue  the  me- 
dicine eight  or  ten  days,  and,  during  the  ufe  of 
it,  he  never  difcovered  any  giddinefs,  blindnefs, 
convulfions,  or  other  dangerous  fymptoms  enu- 
merated by  authors,  to  arife  from  the  ufe  of  it. 
—-He  gave  to  a  boy,  eight  years  old,  ten  grains 
twice  a  day,  and  to  an  adult,  an  half  a  drachm 
four  times  a  day. 

Male  fern.'] 


24  A  DISSERTATION  ON  WORMS 

Male  fern. 1  This  remedy  is  the  celebrated 
fpecific  of  Madam  Noufer,  of  Switzerland,  for 
the  cure  of  the  taenia — Having  attracted  the  no- 
tice of  the  practitioners  of  France,  her  fecret, 
after  being  tried  at  Paris  under  the  direction  of 
fome  eminent  phyficians,  was  purchafed  by  tltiQ 
French  King,  and  publiihed  by  his  order.  The 
virtues  of  this  plant  were  well  known  to  the  an- 
cients, as  early  as  the  days  of  Diofcorides ;  but 
it  is  laid  to  have  been  entirely  neglected.  Galen 
mentions  the  fuccefsful  uie  of  it,  -and  orders  it  to 
be  drank  with  mead. 

In  the  Academy  of  Sciences  of  Paris,  in  the 
year  1701,  Marchand  made  many  experiments 
upon  its  ufe,  and  declares  it  to  be  a  certain  remedy 
in  expelling  all  kind  of  worms. 

Doctor.  Duncan,  in  his  Medical  Cafes,  has 
exhibited  a  cafe  of  taenia,  wherein  the  powder  of 
the  male-fern  proved  fuccefsful.  He  adds,  "  If 
the  prefent  practice  lhall  confirm  the  opinion  of 
the  ancients,  the  restoration  of  this  article,  to  the 
lift  of  the  materia  medica,  may  be  confidered  as  a 
circumstance  of  importance  in  the  practice  of  me- 
dicine." He  fays  alfo,  he  has  every  reafon  for 
prefuming  that  the  expulilon  of  the  taenia  was,  in 
a  great  meafure,  ov/ing  to  the  influence  which  the 

fern 


OF  THE  HUMAN  INTESTINES.  2$ 

fern  powder  exerted,  as  a  degree  of  ficknefs  at 
the  ftomach  arofe  before  any  other  medicine  was 
exhibited. 

The  root  of  the  male  fern,  in  powder,  is  di- 
rected to  be  taken  in  water,  to  two  or  three  drams 
in  the  morning,  no  fupper  having  been  ate  the 
preceding  night — It  generally  fickens  a  little — A 
brifk  cathartic  is  given  a  few  hours  after,  confirm- 
ing of  calomel,  fcammony,  and  gamboge.  This 
frequently  brings  off  the  taenia  entire ;  if  not,  the 
medicine  is  repeated  at  due  intervals. 

The  French  phyflcians  recommend  fome  pre- 
cautions, which  they  affirm  are  elTential  to  the 
fuccefs  of  the  remedy,  as  giving  fome  panada  and 
an  injection,  which  they  prefcribe  the  night  be- 
fore, to  lubricate  the  inteftines,  and  prepare  the 
prims  viae. 

^Form-feed.]  This  feed  has  an  unpleafant  fmell, 
and  a  very  bitter  tarte ;  and,  on  account  of  thefe 
qualities,  the  form  of  powder  and  decoction  is 
rendered  inconvenient — It  is  celebrated  as  a 
vermifuge,  and  is  readily  taken  mixed  with 
molarTes. 

In  the  Medical  Commentaries,  vol.  viii.  page 

213,  the  fuccefsful  effects  of  the  anthelmia  ber- 

D  mudenfis, 


26  A  DISSERTATION  ON  WORMS 

mudenfis,  or  common  worm-grafs,  is  mentioned 
as  an  anthelmintic,  while,  at  the  fame  time,  it  is 
perfectly  inoffenfive.  It  is  fuppofed  to  be  the  fame 
plant  from  which  the  femen  fantonicum,  or  worm- 
feed,  is  taken:  It  may  be  given  in  infufion; 
but  the  author  found  the  following  a  pretty  certain 
vermifuge — R.  Ayth&fm:  Occident alis  (common 
worm-grafs)  unciam  unam,  CanelL  Alb.  fcrupulos 
duos,  puh.  jalap,  fcrupulum  unum,  vitriol,  cceral 
grana  decern  M.  From  ten  grains  to  two  fcruples 
may  be  given  once  or  twice  a  day,  according  to 
the  age  of  the  perfon. 

Common  fall .]  From  the  experiments  related 
in  the  Medical  Commentaries,  vol.  viii.  page  342, 
and  thofe  of  the  ingenious  Doctor  Rufh,  of  Phi- 
ladelphia, of  the  fudden  and  powerful  influence 
of  this  fait  in  killing  worms  out  of  the  body,  I 
have  been  led  to  mention  it  here.  In  the  experi- 
ments alluded  to,  a  watery  folution  of  this  fait  be- 
ing applied  to  earth-worms  ftrongly  convulfed 
them  in  one  or  two  minutes,  in  three  they  became 
motionlefs,  and  in  four  minutes  they  died. 

Doctor  Rufh  fays,  he  "  adminiftered  many 
pounds  of  common  fait,  coloured  with  cochineal, 
in  dofes  of  half  a  drachm,  upon  an  empty  ftomach 
in  the  morning,  with  great  fuccefs  in  deflroying 

We 


OF  THE  HUMAN  INTESTINES.  2'/ 

We  might  go  on  to  enumerate  many  more  ar- 
ticles which  act  by  their  deleterious  quality,  but 
the  limits  of  this  dirTertation  will  not  permit. 
Thofe  of  the  moft  approved  efficacy  have  been 
felected,  and  briefly  treated. 

2.  The  mechanical  medicines  act  directly  and 
indirectly  upon  worms. 

Those  of  the  hrft  kind  are  cowhage,  filings 
of  fleel,  and  powder  of  tin. 


?.]  The  efficacy  of  this  plant  is  now 
indiiputable,  and  the  dangerous  confequences  ap- 
prehended formerly  from  its  contact  with  the 
coats  of  the  ftomach  and  inteftines,  are  now  hap- 
pily removed. 

The  parts  of  this  plant  which  are  made  ufe  of, 
are  the  fpiculs  or  hairy  fubflance  growing  on  the 
outfide  of  the  pod.  Thefe  are  given  mixed  with 
rnolarTes  or  common  fyrup.  The  fpiculas  of  one 
pod  are  faid  to  be  a  fufficient  quantity  for  an  adult. 

A  Practitioner*  who  reiided  in  the  Weft- 
Indies,  previous  to  the  late  war,  made  feveral  ex- 
periments to  determine  whether  the  innocency  of 
the  remedy,  when  taken  into  the  ftomach,  was  to 
be  attributed  to  the  mode  of  its  exhibition,  or  to 

the 
*  Doftor  Samuel  KifTam's  Inaug.  Eflay, 


28  A  DISSERTATION  ON  WORMS 

the  mucus  with  which  the  ftomach  is  lined ;  judges 
ing  its  activity  might  be  blunted  by  the  fyrup  of 
the  one,  and  mucus  of  the  other,  which,  however, 
proved  not  to  be  the  cafe.  He  applied  to  the  back 
of  one  of  his  hands  a  fmall  portion  of  the  dry  fpi- 
culse,  and  to  the  other  a  like  quantity  mixed  with 
fyrup,  without  being  able  to  perceive  any  difference 
in  their  effects,  in  point  of  duration  or  feverity : 
Hence  he  concludes  the  ftimulating  properties  of 
cowhage  are  conveyed  into  the  ftomach  with  it. 

In  the  next  experiment  he  blended  a  fmalj 
quantity  of  the  fpicujse  with  fome  faliva,  and  put 
it  to  the  back  of  his  hand ;  at  the  fame  time  he 
took  fome  dry  cowhage  into  his  mouth,  and  ob- 
ferved  that  what  he  had  applied  to  his  hand  quick- 
ly produced  conhderable  uneafinefs,  while  that 
which  was  taken  into  the  mouth  had  no  feniible 
effect. 

Finding  its  ftimulating  effects  to  be  fo  gentle 
and  inoffenfive  upon  the  parts  lining  the  mouth 
and  inteftines,  and  not  knowing  any  other  quality 
to  which  its  properties  as  an  anthelmintic  could  be 
attributed,  more  particularly  as  he  had  adminifter- 
td  it  in  tincture  and  decoction,  without  any  evi- 
dent advantage,  he  made  the  following  experi- 
ment, which  removed  the  objections: — 

To 


OF  THE  HUMAN  INTESTINES.  29 

To  a  number  of  earth-worms,  when  quiet 
and  undifturbed,  he  applied  Tome  cowhage,  and 
as  foon  as  it  came  in  contact  with  them,  they 
manifefted  figns  of  uneafinefs,  by  their  violent 
agitation  5  and  the  fame  thing  was  noticed  when 
applied  to  them  united  with  molafles  or  iyrup, 
and  it  eventually  proved  their  death. 

Filings  offteeW]  This  preparation  is  exhibited 
againft.  the  lumbrici  and  taenia.  Some  phyficians 
have  adrniniftered  it  to  the  quantity  of  a  drachm 
in.  a  day,  which  was  repeated  for  fever al  fucceiTive 
days. 

Powder  of  tin.]  This  has  been  fuppofed  to 
act.  as  a  poifon  to  the  worms,  from  the  ar'fenic 
that  is  combined  with  it  in  its  pureft  ftate  \  but 
from  tliQ  length  of  time  a  worm  can  live  in  a  folu- 
tion  of  white  arfenic,  it  is  more  likely  that  the  tin 
ads  entirely  by  its  mechanical  property  upon 
the  worms. 

Professor  Alfton  publifhed  in  the  Medical 
EfTays,  vol.  v.  page  90,  an  empirical  remedy  of 
tin  againft  worms,  from  which  he  experienced  great 
fuccefs.  The  method  he  prefcribes  for  ufing 
it  was  as  follows : — For  an  adult  perfon,  to  have 
£wo  ounces  of  the  pureft  powder  of  tin  mixed 

with 


5'0  A  DISSERTATION  ON  WORMS 

with  eight  ounces  of  common  fyrup  or  molaues^ 
and  previoufly  to  its  exhibition,  to  have  the  bowels 
well  emptied  by  an  infufion  of  fenna  and  manna, 
&c.  The  day  following,  fuppofe  Monday,  he 
directs  one  half  of  this  mixture  to  be  taking  early 
in  the  morning,  upon  a  farting  ftomach.  On 
Tuefday,  at  the  fame  time,  he  orders  a  fourth 
part  of  it ;  and,  on  Wednefday,  the  remainder, 
in  like  manner  as  the  former -,  and  laftly,  on 
Thurfday  he  again  directs  the  patient  to  be  purg- 
ed by  the  above  purgative  medicine,  to  evacuate 
the  worms  in  the  body. 

The  celebrated  Doctor  Mead*  found  the  file- 
ings  of  tin  a  moft  efficacious  remedy  againft  the 
taenia,  and  made  ufe  of  it  for  a  very  long  time 
before  he  publifned  it.  He  took  equal  portions 
of  filings  of  tin  and  red  coral,  reduced  to  a  very 
fine  powder ;  a  drachm  of  which  he  directs  to  be 
taken,  made  into  a  bolus,  with  conferve  of  the 
tops  of  wormwood,  twice  in  a  day. 

The  mechanical  medicines  which  act  indirectly 
upon  the  worms,  are  vomits,  purges,  and  thofe 
remedies  that  give  tone  and  vigour  to  the  ftomach 
and  bowels. 

3.  The 

*  R.  Mead's  Picerepta  Med.  cap.  de  Lumbricis. 


of  the  human  intestines.  31 

3,  The  remedies  which  act  by  their  mechanical 
and  poifonous  qualities  conjointly,  are  calomel 
and  jalap.  Thefe  are  fafe  and  powerful  •,  they 
often  caufe  an  evacuation  of  worms  when  given 
with  other  intentions. 

II.  The  worms  being  diflodged  or  killed,  they 
are  to  be  expelled  from  the  body. 

This  indication  may  be  fulfilled,  by  exhibiting 
in  constitutions  that  are  pretty  ftrong,  all  thofe 
purgative  medicines  accounted  draftic,  as  gam- 
boge, fcammony,  infufion  of  fenna  and  falts,  &c, 
&c.  &c.  But  in  children  powdered  rhubarb  alone, 
or  united  with  mercurius  dulcis,  is  an  effectual 
purgative,  and  anfwers  extremely  well. 

From  the  fituation  of  the  afcarides  in  the  in- 
teftines,  medicines  taken  by  the  mouth  very  rare- 
ly preferve  their  efficacy  until  they  arrive  at  the 
inteftinum  rectum,  as  thefe  v/orms  are  princi- 
pally feated  in  it;  hence  they  are  more  im- 
mediately and  effectually  killed  and  expelled  by 
clyflers  of  an  oily,  acrid,  or  fweet  nature,  and  by 
acrid  fuppofitories,  with  remedies  of  a  like  na- 
ture -,  but  what  many  think  more  fafe  and  cer- 
tain remedies,  are  clyftes  of  lime-water,  injections 
of  fulphurious  mineral-waters,  and  the  vapours  of 
tobacco  thrown  up. 

Clysters 


^2  A   DISSIXTA7I0X   OX   WORMS,  &C. 

Clysters  admiuhtrred  a^aiiirr.  the  aicarides 
ought  to  be  frequently  repeated,  as  fometimes 
thev  do  dot  infeft  thie  reftum  in  great  numbers; 

and  in  that  cafe  the  few  that  do,  get  (bated  in  the 

folds  of  the  rectum. 

I:;  the  London  Medical  Transactions  we  have 
an  account  of  a  boy,  who,  as  often  as  he  perceiv- 
ed lymptoms  of  aicarides,  immediately  took  an 
half  pound  of  common  (alt,  difiblved  in  water  ; 
in  confequence  of  which  he  voided  them,  and  af- 
terwards recovered. 

After  having  exhibited  iome  of  the  foregoing 
remedies,  and  having  expelled  the  worms,  it  will 
be  advifeable  to  give,  at  proper  intervals,  iome 
gentle  cathartic ;  and  mould  the  inteftines  be  much 
debilitated,  iome  ilrengthening  medicines  ought  to 
be  taken,  as  bark  and  red  wine;  at  the  fame  time, 
uf:rr£  exerciie :  and  indeed  nothing  feems  to  be 
more  delrru  drive  to  worms,  or  more  effectual  in 
preventing   their  generation,    than   eood   living. 


THE    END 


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